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Version: 3.1

Encounter

Definition

An encounter in Care records one interaction between a patient and your facility. The interaction is an outpatient visit, an admission, an observation stay, an emergency visit, a virtual consultation, or a home visit. The encounter groups everything the care team records for that interaction. A patient can have more than one open encounter at the same facility at the same time.

Note: Your deployment sets the maximum number of open encounters for one patient at a facility. The default maximum is 5.

Care follows the FHIR R5 Encounter resource. An encounter links to these records:

  • The patient who receives the care.
  • The facility and the departments that answer for the care.
  • The location that the patient occupies.
  • The appointment that starts the encounter.

Key Attributes

ComponentsWhat it captures
StatusThe current state of the encounter, for example In Progress.
Type of EncounterThe type of care, for example Inpatient or Ambulatory. The update form calls this field Encounter Class.
PriorityThe urgency of the care, for example Emergency or Routine.
Date and TimeThe date and time when the encounter starts.
Discharge Date and TimeThe date and time when the facility discharges the patient.
Hospital IdentifierA free-text reference number that your facility uses, such as an IP, OP, OBS or EMR number.
DepartmentsThe facility departments that answer for the encounter.
Care teamThe staff who look after the patient, each with a clinical role.
Current locationThe bed, room or ward that the patient occupies.
TagsLabels that your facility configures.
Hospitalization detailsThe admission and discharge information for a patient who stays at the facility.
Discharge Summary AdviceFree text that the team writes for the patient at discharge.

Departments

Each encounter needs at least one department. The departments control who can see the encounter. To change them, see Manage Encounter departments.

Care team

The care team lists the staff who look after the patient. Each member holds a clinical role. One member carries the primary marker. To change the team, see Manage the Encounter care team.

Tags

Your facility configures the tags. Care groups them in these categories:

  • Diet
  • Drug
  • Lab
  • Admin
  • Contact
  • Clinical
  • Behavioral
  • Research
  • Advance Directive
  • Safety

Type of Encounter

Type of EncounterDescription
InpatientPatient is admitted to the hospital.
AmbulatoryPatient visits for outpatient care.
ObservationPatient is under observation.
EmergencyMark as emergency if immediate attention is required.
VirtualVirtual/telehealth consultation.
Home HealthCare provided at patient's home.

Note: Your deployment decides which types staff can choose. Your deployment also decides which type Care preselects.

Priority

The priority states how urgent the care is. Care offers these priorities:

  • Stat
  • ASAP
  • Emergency
  • Urgent
  • Routine
  • Elective
  • Rush reporting
  • Timing critical
  • Callback results
  • Callback for scheduling
  • Pre-op
  • As needed
  • Use as directed

Note: Routine is the default priority on the create form.

Hospitalization details

Hospitalization details appear only for the Inpatient, Observation and Emergency types.

ComponentsWhat it captures
Re-AdmissionWhether the patient comes back for the same problem.
Admit SourceWhere the patient came from.
Discharge DispositionWhere the patient goes after discharge.
Diet PreferenceThe dietary requirement of the patient.

Admit Source offers these values:

  • Transferred from other hospital
  • From accident/emergency department
  • From outpatient department
  • Born in hospital
  • General Practitioner referral
  • Medical Practitioner/physician referral
  • From nursing home
  • From psychiatric hospital
  • From rehabilitation facility
  • Other

Discharge Disposition offers these values:

  • Home
  • Alternate home
  • Other health care facility
  • Hospice
  • Long term care
  • Left against advice
  • Expired
  • Psychiatric hospital
  • Rehabilitation
  • Skilled nursing facility
  • Other

Diet Preference offers these values:

  • Vegetarian
  • Dairy free
  • Nut free
  • Gluten free
  • Vegan
  • Halal
  • Kosher
  • None

Note: Your deployment can set a default discharge disposition. Care pre-fills that value.

Status

The status shows where the encounter is in its life cycle.

StatusDescription
PlannedThe team plans the encounter for a future date.
In ProgressThe team gives care to the patient now.
On HoldThe team pauses the encounter.
DischargedThe facility discharges the patient.
CompletedThe care in this encounter ends.
CancelledThe team cancels the encounter before the care starts.
DiscontinuedThe team stops the encounter before the care ends.
Entered in errorA user creates the encounter by mistake.
UnknownThe status of the encounter is not known.

Care applies no rules about the order of the statuses. While the encounter stays open, you can move it from any status to any other status.

Four statuses lock the encounter: Completed, Cancelled, Discontinued and Entered in error. After the encounter reaches one of these statuses, nobody can edit it. Nobody can record new clinical data on it.

Discharged does not lock the encounter. A discharged encounter stays open for edits. The care team can still change the location, the care team, the departments and the tags. To close a discharged encounter, someone must mark it as complete. See Complete an Encounter.

Note: Your deployment sets how long after its last change someone can restart a completed encounter. The default is zero hours, which stops all restarts.

Where to find Encounters

The facility sidebar holds a Patients group. The group contains Search Patients, one list for each allowed encounter type, and Locations. The group also contains All Encounters when your deployment allows more than one encounter type.

Note: Your deployment sets the default date filter on the encounter lists.

The encounter page holds these tabs: Overview, Plots, Observations, Medicines, Responses, Service Requests, Diagnostic Reports, Files, Notes, Devices and Consents. Every tab except Overview, Devices and Consents needs permission to read clinical data.

The encounter page also holds an Encounter Actions command palette. Press Shift+E to open it.

The Overview tab carries a side panel with these actions:

  • Manage Consents
  • Manage Care Team
  • Update Location
  • Update Department
  • Dispense

The Overview tab also carries a button. The button reads Mark for discharge or Mark as Completed.

A left rail lets you move between the encounters of the patient. The rail filters the encounters by status, department, care team, date and tags.

Permissions

Your role controls what you can do with an encounter. Administrators, Doctors, Nurses and Facility Administrators hold these permissions.

PermissionWhat it allows
Can Create encounterCreate an encounter.
Can Read encounterOpen an encounter.
Can list encountersSee the encounter lists.
Update Encounter non clinicalChange the details of the encounter. Manage its departments, care team, location, tags, completion and restart.
Can Read encounter related clinical dataOpen the clinical tabs.
Update Encounter related clinical dataRecord clinical data.
Can submit questionnaire about patient encountersAnswer questionnaires about the encounter. Staff also hold this permission.

You can also reach an encounter through the department that owns the current bed of the patient. The departments of the encounter are not the only route.